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March 14, 2008

Sleep Hygiene: a self-critique

I recently prepared a presentation on sleep apnea and sleep hygiene. I tacked on the bit about sleep hygiene because it's a concept that's quite foreign to me and I wanted to learn more about it. Quite frankly, I suck. I routinely go to sleep around 3 or 4am and I take a nap in the afternoons to try to catch up on my sleep deficits. On days when I can't take a nap, my mind wanders, I yawn a lot, I feel on the edge of nodding off around 3 or 4pm.

Here's some of the basics about it:

Areas important to sleep hygiene:

Circadian rhythm

Aging

Stress

Common social or recreational drugs like nicotine, caffeine, and alcohol

Adapt your habitso Set a bedtime and waking time (no sleeping in more than 2-3 hours on weekends)o Avoid napping (if you do, make it short and before 3 pm)o Avoid EtOH, caffeine, heavy/spicy/sugary foods 4-6 hours before bedtimeo Exercise! (but not right before bed)

Adapt your environmento Comfortable bed, comfortable temperature, dark roomo Block distractions (NO TV, NO computer for at least an hour or more before, but radio is OK)o Only two S’s for bedo Proper positioning

My waking time varies every day. Basically, I set it as late as possible so I can sleep in because it's just so hard for me to get up in the morning. I nap around 4-5pm whenever I can, which is usually 2 or 3 times a week. My naps are about 1-2 hours long, depending on what finally rouses me (usually hunger). On the plus side for me, I hardly ever snack late at night (but it's not really a problem for me to go to bed once I'm there. It's more an issue of studying when I feel most mentally alert... it's just unfortunate that it happens to be 10pm onward.

My environment for sleeping is pretty good. I actually sleep on a bed now, which different from the ~20 years of sleeping on a futon at home (the parents' place) One of my S's is lacking... I've pretty much replaced it with another S: studying.

My pre-sleep ritual usually involves brushing my teeth for close to half an hour while I browse blogs on the internet (or on especially good days, I decide to blog!) Perhaps an unwise decision, since the lights from the computer screen and the content of the blogs stimulate me and I decide "oooh, another 15 min wouldn't hurt..." and before I know it, it's 3am and I've got class at 830 tomorrow.

So my sleep hygiene is about as bad as it could be. If I want to start sleeping earlier and reset my circadian rhythm to a more decent hour, I've got to exercise more, stop my midnight blog browsing, and stop studying in bed. I should have a warm glass of soy milk, settle in with a book and read for about 15 minutes before turning in at midnight.

Ha! I wonder if that's even possible to manage, med school and beyond.

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About: This is a blog by a physician on medicine, philosophy, ethics, and education.

Disclaimer: information on this blog is for medical entertainment purposes only, learning is optional. Whatever you read here does not constitute as medical advice; it is merely not my second opinion. Any similarity to real patient stories are purely coincidental, all private information has been deidentified to HIPAA standards and fictionalized to protect the innocent.

My words are my own and do not reflect the thoughts/opinions of My Medical School, My Hospital, My Clinic, My Employer or any other Unfortunate Souls who have had the ill-fortune of associating with me.